Life Inside Canine Rehabilitation

Going through physical therapy school, we learn the essential aspects of what it takes to rehabilitate people with various pathologies. We are instilled with the basic understanding of prescribing exercises and optimizing human movement. But there’s also a field of physical therapy that works with subjects other than humans, and that’s dogs. When coming across the idea of working with canine patients, one must ask themselves, “Where do I start? How is this going to change my career?”

I reached out to an expert in canine rehabilitation, Karen Atlas, MPT, CCRT, and asked her to share her story about what it’s like to work with canine patients and how she got to where she is today.  This is a shorter version of her entry within a book called “Successful Practitioners in Canine Rehabilitation & Physiotherapy.”

The Inspiration

            “ My life changed after adopting my injured dog, Teddy. I was told by several veterinarians that his lameness would resolve with restricted activity and medications. Unfortunately, he was allergic to the prescribed medications, and became very ill. I went to many different veterinarians for second, third and fourth opinions, but none could help my Teddy.

Trained as a human physical therapist, I hoped that I could use my rehabilitation skills to relieve his pain; I knew, though, that I needed specialized training in canine anatomy and biomechanics. I searched the Internet at first with the intention of taking a canine anatomy course just so I could find how I could use some of my human-trained techniques on Teddy. But my search led me much deeper than I anticipated. It was during that time that I learned that certification in canine rehabilitation was possible, and found that the Canine Rehabilitation Institute was a good match for me. I was "all in" after that point.

Canine rehabilitation soon became my passion. Little did I know when I adopted my sweet Teddy that he would completely change my career direction and life (and the lives of many more of his species!). Canine rehab was a perfect fit for me as it meshed my love for dogs with a profession that I had already been successfully practicing for 12 years.

I was very fortunate to meet a leader in the field of veterinary medicine, Dr. Kenneth Bruecker, Board Certified Veterinary Surgeon. He was looking for a licensed physical therapist with advanced training in canine rehabilitation to lead his new rehab clinic within his highly regarded referral-only specialty hospital, Veterinary Medical and Surgical Group (VMSG). I worked with Dr. Bruecker and developed the new department, eventually leaving his practice to be closer to home following the birth of my first child.

I then teamed up with a local veterinarian, Dr. Dave Dawson, who completed his certification classes and created a canine rehabilitation clinic behind his existing practice called Hydropaws Animal Rehabilitation and Performance Center. Dr. Dawson was too busy to run both a veterinary hospital and a rehab clinic, and understood the importance of having a licensed physical therapist trained in canine rehabilitation as part of the team to grow the rehab center. I have been the Director of Hydropaws now for over 5 years; in addition to patient care, I am responsible for overall management, program development, training, and staffing.

(Editor’s note: For more about Hydropaws and the equipment they utilize, click here to watch a video that shows some of the equipment used to rehab a paralyzed dog.) 

The Practice / Typical Visits

 “Hydropaws is a dedicated rehabilitation facility attached to a well-regarded veterinary hospital. The veterinary hospital has six veterinarians on staff. We have two underwater treadmills, a land treadmill, two class 3B cold laser units, an ultrasound/electrical stimulation combo unit, a portable neuromuscular electrical stimulation (NMES) unit, a portable TENS unit, a pulsed electromagnetic field (PEMF) mat, an Alpha-Stim machine, a treatment table, and a wide range of other equipment, ranging from physioballs, balance discs and wobble boards, to caveletti poles, a ramp, an exercise ladder and stairs.

We have about 45-55 visits each week, with some patients requiring multiple visits. The caseload consists of approximately 70% Ortho, 20% Neuro, and 10% Geriatrics. We employ three aides (one full time and two part-time, at approx 25-30 hours each), and benefit from the support staff of the adjacent veterinary hospital. As the only therapist, I frequently have waiting lists for new clients.

We require a veterinarian referral to begin the rehab process. Once it has been determined that the animal is medically stable to safely undergo rehabilitation, we receive the referral, obtain all medical records, and schedule an initial evaluation.

Upon a patient’s first visit, we require intake paperwork, which includes a functional questionnaire (past and present functional abilities and client goals for rehab), and consent forms (right to use photography/video for treatment and marketing purposes, cancellation policy, etc.). Initial appointments require 75-90 minutes and they include a comprehensive evaluation and treatment for that day. During this time, I am assisted by an aide who helps with animal handling and documents my findings so my focus can remain on the patient and client. After a thorough assessment, I discuss my findings with the client. I then make my recommendations for a treatment plan to reach their specific goals and we schedule additional appointments, as needed. The client leaves with a solid understanding of what their pet is facing and what steps we are going to take to improve their quality of life and reach their goals based on as much evidence-based research as possible. Subsequent sessions then range from 30-75 minutes.

Karen also discusses important key points that involve the marketing process for working with canines, the ingredients for success, the barriers to success, her struggles, and advice for pursuing excellence. These and other stories can be found within “Successful Practitioners and Canine Rehabilitation & Physiotherapy.” It is an excellent book for anyone who is considering a career working with canines.

How to become certified in canine rehabilitation (CCRT)?

In order to be able to work with canines, a certification is required. Through the Canine Rehabilitation Institute, this is possible. Within their CCRT courses, the candidates learn:

  • Canine anatomy and physiology
  • Conditions and injuries commonly referred for rehabilitation
  • Physical therapy assessment techniques
  • Manual therapy
  • Physical modalities and therapeutic exercise
  • Neurological rehabilitation
  • The business of canine rehabilitation

Within the CCRT curriculum, there are 3 courses that must be taken and these courses will require you to have a pretty penny to purchase them:

  • Introduction to Canine Rehabilitation…………………...$2750
  • The Canine Rehabilitation Therapist…………………….$2750
  • Canine Sports Medicine …………………………………….....$1500
    •  Total Course Fee…………..$7000

For more information, visit their site by clicking here.

Another program that is available to become certified is through the University of Tennessee.  This program offers a certification, upon completion, called Certified Canine Rehabilitation Practitioner (CCRP).                                      
Their information can be found here.  
Essentially CCRT and CCRP are the same credential-type. Neither program has an oversight agency as of yet due to the infancy of the profession.


One of the struggles that comes along with working in the field of canine rehabilitation educating the Veterinarians who have not been exposed to working in collaboration with other allied health professionals.  Similar to our profession currently experiencing various battles we face against Chiropractors, Acupuncturists, Physicians, etc., canine specialists battle against Veterinarians.  Currently in the state of California, the Veterinarian Medical Board (VMB) is seeking to add language in their practice act which would put qualified therapists under the direct supervision of a veterinarian. To protect the right of the consumers to choose who they want to treat their pets, the California Association of Animal Physical Therapists (CAAPT) is lobbying against this strict, career-limiting language.  If canine rehabilitation is somewhere you want to be, make sure you advocate their rights to allow advanced, trained physical therapists to work independently (if desired) and to own their own practices, as long as medical clearance is made for each patient and communication is maintained with the referring veterinarian through the rehab process. To support Karen's team and all of the physical therapists who have pursued being able to treat this special population, visit her GoFundMe page and consider making a donation. Please also consider getting involved with advocacy to advance the field for physical therapists practicing in this specialty niche of animal healthcare by visiting